European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Exeter, UK.
Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and Health, University of Exeter, Exeter, UK.
Int J Older People Nurs. 2021 Sep;16(5):e12391. doi: 10.1111/opn.12391. Epub 2021 Jun 1.
Guidance on provision of care for people with dementia states that occupation people find meaningful is essential for well-being; however, definitions of 'meaningful occupation' are often broad, with intrinsic meaning coming from within the person rather than the activity, leading to an inconsistent understanding of its purpose.
This study aimed to create a conceptual framework depicting the types of meaning that are seen as stemming from occupation.
Six electronic databases were searched (CINAHL, PubMed Central, PsycINFO, Embase, AMED, ASSIA) using a pre-specified search strategy to identify qualitative studies relating to meaningful occupation for people living with dementia. From 114 eligible full-text articles, six qualitative studies were identified as sufficiently rich, topically relevant and explicit in their definition of meaningful activity. A further 14 were purposefully sampled for their ability to refute or advance the emerging conceptual framework. The synthesis is based on meta-ethnography and is reported following eMERGe guidance.
We found the fundamental purpose of occupation is to support the person living with dementia to feel they are living a meaningful and fulfilling life. Three overlapping concepts were identified: (i) catalytic environment, (ii) meaningful life and (iii) occupation as a tool.
The framework proposes how occupation could support meaning in multiple ways and considers how these forms of meaning were influenced by the worldviews and values of the individual, and context in which they were experienced.
The conceptual framework offers a consistent theoretical grounding with which to measure effectiveness of meaningful occupation for people living with dementia.
有关痴呆症患者护理的指南指出，人们从事有意义的工作对其福祉至关重要；然而，“有意义的工作”的定义往往很宽泛，其内在意义来自于个人本身，而不是活动本身，这导致了人们对其目的理解不一致。
本研究旨在创建一个概念框架，描述从职业中产生的意义类型。
使用预先设定的搜索策略，在六个电子数据库（CINAHL、PubMed Central、PsycINFO、Embase、AMED、ASSIA）中进行搜索，以确定与痴呆症患者有意义的职业相关的定性研究。从 114 篇符合条件的全文文章中，确定了 6 项定性研究，这些研究在有意义的活动的定义方面足够丰富、主题相关且明确。另外 14 项是根据其反驳或推进新兴概念框架的能力有目的地抽样的。综合分析基于元民族志方法，并按照 eMERGe 指南进行报告。
我们发现，职业的基本目的是支持痴呆症患者，使他们感到自己过着有意义和充实的生活。确定了三个重叠的概念：（i）催化环境，（ii）有意义的生活和（iii）职业作为工具。
该框架提出了职业如何以多种方式支持意义，并考虑了这些意义形式如何受到个人世界观和价值观以及他们所经历的环境的影响。
该概念框架为衡量痴呆症患者有意义的职业的有效性提供了一个一致的理论基础。
